Pharmacy Resident/ Fellow - Managed Care
About The Position
This position is responsible for developing, implementing, monitoring and assisting in projects/programs that enhance the care of members in both commercial and Medicare advantage health plans. This position is also responsible for assisting the Pharmacy Health Plan Services area in the management of the Medicare Advantage Part D prescription benefits and after-hour prior authorizations as needed. Under the supervision of the Director of Pharmacy– Health Plan Services, this position is routinely responsible for audits and monitoring functions that help ensure prescription benefits are administered cost effectively, timely, accurately and in compliance with CMS standards.
Requirements
- Graduate School of Pharmacy
- Intern state license; must obtain Texas Pharmacy License within 90 days of hire
- 1+ years of pharmacy experience
- Proven ability to communicate with other healthcare and company personnel to delegate duties, inform about policies, train, assist with program development and implementation
- Proven ability to communicate with members to handle complaints and problems, assist with questions, and recommend products.
Nice To Haves
- HMO and 3rd party managed care experience
- Experience with presentations
- Proven ability to problem solve and to present suggestions and solutions in a clear and concise manner
Responsibilities
- Develop, implement, and monitor projects/programs that enhance the care of members in all health plans as well as the financial abilities of the department
- Assist with data collection interpretation and reporting
- On Call for Prior Authorizations.
- Other duties as assigned
Benefits
- comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
